Impact of Pre-Dialysis Care on Clinical Outcomes in Peritoneal Dialysis Patients
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1159/000444401 http://hdl.handle.net/11449/177887 |
Resumo: | Background: Structured pre-dialysis care is associated with an increase in peritoneal dialysis (PD) utilization, but not with peritonitis risk, technical and patient survival. This study aimed at analyzing the impact of pre-dialysis care on these outcomes. Methods: All incident patients starting PD between 2004 and 2011 in a Brazilian prospective cohort were included in this analysis. Patients were divided into 2 groups: early pre-dialysis care (90 days of follow-up by a nephrology team); and late pre-dialysis care (absent or less than 90 days follow-up). The socio-demographic, clinical and biochemical characteristics between the 2 groups were compared. Risk factors for the time to the first peritonitis episode, technique failure and mortality based on Cox proportional hazards models. Results: Four thousand one hundred seven patients were included. Patients with early pre-dialysis care presented differences in gender (female-47.0 vs. 51.1%, p = 0.01); race (white-63.8 vs. 71.7%, p < 0.01); education (<4 years-61.9 vs. 71.0%, p < 0.01), respectively, compared to late care. Patients with early pre-dialysis care presented a higher prevalence of comorbidities, lower levels of creatinine, phosphorus, and glucose with a significantly better control of hemoglobin and potassium serum levels. There was no impact of pre-dialysis care on peritonitis rates (hazard ratio (HR) 0.88; 95% CI 0.77-1.01) and technique survival (HR 1.12; 95% CI 0.92-1.36). Patient survival (HR 1.20; 95% CI 1.03-1.41) was better in the early pre-dialysis care group. Conclusion: Earlier pre-dialysis care was associated with improved patient survival, but did not influence time to the first peritonitis nor technique survival in this national PD cohort. |
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Impact of Pre-Dialysis Care on Clinical Outcomes in Peritoneal Dialysis PatientsClinical outcomesPeritoneal dialysisPre-dialysis careSurvivalBackground: Structured pre-dialysis care is associated with an increase in peritoneal dialysis (PD) utilization, but not with peritonitis risk, technical and patient survival. This study aimed at analyzing the impact of pre-dialysis care on these outcomes. Methods: All incident patients starting PD between 2004 and 2011 in a Brazilian prospective cohort were included in this analysis. Patients were divided into 2 groups: early pre-dialysis care (90 days of follow-up by a nephrology team); and late pre-dialysis care (absent or less than 90 days follow-up). The socio-demographic, clinical and biochemical characteristics between the 2 groups were compared. Risk factors for the time to the first peritonitis episode, technique failure and mortality based on Cox proportional hazards models. Results: Four thousand one hundred seven patients were included. Patients with early pre-dialysis care presented differences in gender (female-47.0 vs. 51.1%, p = 0.01); race (white-63.8 vs. 71.7%, p < 0.01); education (<4 years-61.9 vs. 71.0%, p < 0.01), respectively, compared to late care. Patients with early pre-dialysis care presented a higher prevalence of comorbidities, lower levels of creatinine, phosphorus, and glucose with a significantly better control of hemoglobin and potassium serum levels. There was no impact of pre-dialysis care on peritonitis rates (hazard ratio (HR) 0.88; 95% CI 0.77-1.01) and technique survival (HR 1.12; 95% CI 0.92-1.36). Patient survival (HR 1.20; 95% CI 1.03-1.41) was better in the early pre-dialysis care group. Conclusion: Earlier pre-dialysis care was associated with improved patient survival, but did not influence time to the first peritonitis nor technique survival in this national PD cohort.School of Medicine Pontifícia Universidade Católica Do Paraná (PUCPR), Rua Imaculada Conceição, 1155Pontifícia Universidade Católica Do Rio Grande Do sul (PUCRS)Universidade Estadual Paulista-UNESPUniversidade Federal de Juiz de Fora-UFJFUniversidade Estadual Paulista-UNESPPontifícia Universidade Católica Do Paraná (PUCPR)Pontifícia Universidade Católica Do Rio Grande Do sul (PUCRS)Universidade Estadual Paulista (Unesp)Universidade Federal de Juiz de Fora-UFJFSpigolon, Dandara N.De Moraes, Thyago P.Figueiredo, Ana E.Modesto, Ana PaulaBarretti, Pasqual [UNESP]Bastos, Marcus GomesBarreto, Daniela V.Pecoits-Filho, Roberto2018-12-11T17:27:34Z2018-12-11T17:27:34Z2016-04-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article104-111application/pdfhttp://dx.doi.org/10.1159/000444401American Journal of Nephrology, v. 43, n. 2, p. 104-111, 2016.1421-96700250-8095http://hdl.handle.net/11449/17788710.1159/0004444012-s2.0-849612194732-s2.0-84961219473.pdf54964119838934790000-0003-4979-4836Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengAmerican Journal of Nephrology1,4801,480info:eu-repo/semantics/openAccess2024-08-14T17:37:04Zoai:repositorio.unesp.br:11449/177887Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-14T17:37:04Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Impact of Pre-Dialysis Care on Clinical Outcomes in Peritoneal Dialysis Patients |
title |
Impact of Pre-Dialysis Care on Clinical Outcomes in Peritoneal Dialysis Patients |
spellingShingle |
Impact of Pre-Dialysis Care on Clinical Outcomes in Peritoneal Dialysis Patients Spigolon, Dandara N. Clinical outcomes Peritoneal dialysis Pre-dialysis care Survival |
title_short |
Impact of Pre-Dialysis Care on Clinical Outcomes in Peritoneal Dialysis Patients |
title_full |
Impact of Pre-Dialysis Care on Clinical Outcomes in Peritoneal Dialysis Patients |
title_fullStr |
Impact of Pre-Dialysis Care on Clinical Outcomes in Peritoneal Dialysis Patients |
title_full_unstemmed |
Impact of Pre-Dialysis Care on Clinical Outcomes in Peritoneal Dialysis Patients |
title_sort |
Impact of Pre-Dialysis Care on Clinical Outcomes in Peritoneal Dialysis Patients |
author |
Spigolon, Dandara N. |
author_facet |
Spigolon, Dandara N. De Moraes, Thyago P. Figueiredo, Ana E. Modesto, Ana Paula Barretti, Pasqual [UNESP] Bastos, Marcus Gomes Barreto, Daniela V. Pecoits-Filho, Roberto |
author_role |
author |
author2 |
De Moraes, Thyago P. Figueiredo, Ana E. Modesto, Ana Paula Barretti, Pasqual [UNESP] Bastos, Marcus Gomes Barreto, Daniela V. Pecoits-Filho, Roberto |
author2_role |
author author author author author author author |
dc.contributor.none.fl_str_mv |
Pontifícia Universidade Católica Do Paraná (PUCPR) Pontifícia Universidade Católica Do Rio Grande Do sul (PUCRS) Universidade Estadual Paulista (Unesp) Universidade Federal de Juiz de Fora-UFJF |
dc.contributor.author.fl_str_mv |
Spigolon, Dandara N. De Moraes, Thyago P. Figueiredo, Ana E. Modesto, Ana Paula Barretti, Pasqual [UNESP] Bastos, Marcus Gomes Barreto, Daniela V. Pecoits-Filho, Roberto |
dc.subject.por.fl_str_mv |
Clinical outcomes Peritoneal dialysis Pre-dialysis care Survival |
topic |
Clinical outcomes Peritoneal dialysis Pre-dialysis care Survival |
description |
Background: Structured pre-dialysis care is associated with an increase in peritoneal dialysis (PD) utilization, but not with peritonitis risk, technical and patient survival. This study aimed at analyzing the impact of pre-dialysis care on these outcomes. Methods: All incident patients starting PD between 2004 and 2011 in a Brazilian prospective cohort were included in this analysis. Patients were divided into 2 groups: early pre-dialysis care (90 days of follow-up by a nephrology team); and late pre-dialysis care (absent or less than 90 days follow-up). The socio-demographic, clinical and biochemical characteristics between the 2 groups were compared. Risk factors for the time to the first peritonitis episode, technique failure and mortality based on Cox proportional hazards models. Results: Four thousand one hundred seven patients were included. Patients with early pre-dialysis care presented differences in gender (female-47.0 vs. 51.1%, p = 0.01); race (white-63.8 vs. 71.7%, p < 0.01); education (<4 years-61.9 vs. 71.0%, p < 0.01), respectively, compared to late care. Patients with early pre-dialysis care presented a higher prevalence of comorbidities, lower levels of creatinine, phosphorus, and glucose with a significantly better control of hemoglobin and potassium serum levels. There was no impact of pre-dialysis care on peritonitis rates (hazard ratio (HR) 0.88; 95% CI 0.77-1.01) and technique survival (HR 1.12; 95% CI 0.92-1.36). Patient survival (HR 1.20; 95% CI 1.03-1.41) was better in the early pre-dialysis care group. Conclusion: Earlier pre-dialysis care was associated with improved patient survival, but did not influence time to the first peritonitis nor technique survival in this national PD cohort. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-04-01 2018-12-11T17:27:34Z 2018-12-11T17:27:34Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1159/000444401 American Journal of Nephrology, v. 43, n. 2, p. 104-111, 2016. 1421-9670 0250-8095 http://hdl.handle.net/11449/177887 10.1159/000444401 2-s2.0-84961219473 2-s2.0-84961219473.pdf 5496411983893479 0000-0003-4979-4836 |
url |
http://dx.doi.org/10.1159/000444401 http://hdl.handle.net/11449/177887 |
identifier_str_mv |
American Journal of Nephrology, v. 43, n. 2, p. 104-111, 2016. 1421-9670 0250-8095 10.1159/000444401 2-s2.0-84961219473 2-s2.0-84961219473.pdf 5496411983893479 0000-0003-4979-4836 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
American Journal of Nephrology 1,480 1,480 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
104-111 application/pdf |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
_version_ |
1808128211590053888 |